Authors:
JoAnne S.
Wilson
Carolyn L. Cason
Neena L. Grissom
Little Rock, Arkansas
This study evaluated the usefulness of a distraction intervention, an illusion kaleidoscope, for reducing perception of pain in adults undergoing a short-term pain procedure (venipuncture). The study also assessed the appropriateness of the Wong-Baker FACES pain assessment instrument (developed for use with children) for measuring pain in adults.
A Convenience sample (n = 97) of patients in a family practice clinic was used for this study Patients were randomly assigned to either a control group (n = 51), with venipuncture performed in the usual manner, or to an experimental group (n = 46), with venipuncture done while subjects looked through a kaleidoscope. All subjects were between 21 and 65 years old ( n = 42; SD = 12 ); there were 25 men and 72 women. The subjects had an average of 14 years of education (SD = 3). The ratio of white patients to black patients was about 2:1. The groups were found to be equivalent with regard to such variables as age, education, previous venipuncture history, and ethnicity. Pain perception was assessed before and after venipuncture with the Wong-Baker FACES pain assessment scale, Visual Analog Scale (VAS) for pain, and the Present Pain Intensity scale (PPI). Before the test, subjects reported how they thought venipuncture would feel; after the procedure, they indicated how venipuncture actually felt.
Analysis of covariance evaluated posttest differences Postvenipuncture scores served as the dependent variaIle, and prevenipuncture scores were used as covariates. The analysis revealed that perception of pain was significantly reduced for subjects who used the distraction intervention. The statistical data were as follows: FACES: F = 14, df = 1,93; p < 0.01; VAS: F = 2.6, df = 1,93; p = 0.02; PPI: F = 13, df = 1,93; p < 0.01. Correlations among the three pain assessment scales were high (VAS and PPI, r = 0 66; VAS and FACES, r = 0.67; PPI and FACES, r = 0.79), and all correlations were significant (p < 0 01). These findings suggest that the FACES scale, a simple instrument with low literacy demand, can be used to measure pain perception in adults.
Venipuncture, often considered a "routine ED procedure,'' is an anxiety-provoking procedure. For patients who are already in a vulnerable state, like most patients seen in the emergency department, a simple, independent nursing intervention such as distraction with a kaleidoscope can help to make a common experience- venipuncture-less distressing. The ease and simplicity of using the FACES pain assessment scale make it a valuable tool in a clinical setting like the emergency department.
J EMERG NURS 1995;21:87
Copyright 1995 by the Emergency Nurses
Association.
Carolyn Cason, PhD, RN, College of Nursing, University of
Arkansas for Medical Sciences
4301 W. Markham, Slot 529, Little Rock, AR
72205
501-686-5374
March 15, 2002
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